Individual provider Active NPI

Kristin Elizabeth Goodrich, DPT

  • Physical Therapist
  • San Francisco, CA
National Provider Identifier
1942743307
Registry record updated Dec 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT292472 Issued in CA
Practice address
1162 B Gorgas Ave
San Francisco, CA 94129
Phone
(415) 561-6655
Fax
(415) 561-6650
NPI assigned
Dec 2, 2016
Last updated
Dec 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT292472 CA Primary

Addresses

Primary practice location

1162 B Gorgas Ave
San Francisco, CA 94129

Mailing address

1162 B Gorgas Ave
San Francisco, CA 94129
Phone (415) 561-6655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161222000790 CA Practitioner - Physical Therapist in Private Practice 4183905565 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Inner Bar IncGroup PAC ID 2163451634, 12 clinicians

Practice addresses (Care Compare)

2121 19TH Ave
Suite 100
San Francisco, CA 94116-1865
Phone (415) 505-1767

3401 Taraval St
San Francisco, CA 94116-2050
Phone (415) 682-9902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT292472CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Bar, Inc. Physical Therapist CurrentSince Jan 1, 2020 Accepting new patients
Kristin Goodrich Physical Therapy Inc Physical Therapist Current Accepting new patients

Locations

3401 Taraval St
San Francisco, CA 94116
Phone (415) 682-9902

550 15th St
Ste 36A
San Francisco, CA 94103
Phone (415) 682-9902

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1942743307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1162 B GORGAS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94129",
            "telephone_number": "415-561-6655",
            "fax_number": "415-561-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1162 B GORGAS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94129",
            "telephone_number": "415-561-6655",
            "fax_number": "415-561-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODRICH",
        "first_name": "KRISTIN",
        "middle_name": "ELIZABETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-02",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT292472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.